S.A.R.L. Bacchus… Immobilier & Insurance

Second Applicant:
   Title:                    
   First Name(s):               Surname: 
   Date/Place of Birth:               Nationality: 

   Marital Status:           Single    Married    Separated    Divorced    Widowed 
   Date/Place Married:             Date/Place Divorced: 

   Dependent Children/Ages:  

   Home Address: 
	   		      
   At This Address Since:     
   Are You ?    Owner Occupier:      Tenant:   If Tenant, Monthly Rent: euroGBP

   Email:       
   Tel:  (home) 		Fax:  	
   Tel:  (work) 		Mobile: 

   Current Account, Name of Bank:   Since (approx): 

   Employment:   Full Time    Part Time    Self Employed    Retired    Other 
		 if Other - Please Specify 

   Occupation:     Since:  
   Position:      
   Employers Name & Address:
 	 	   

   Gross Monthly Income - Euros:  
   Gross Monthly Income - Other Currency:  

   Monthly Repayments on Existing Mortgage/Loans - Euros:  
   Monthly Repayments on Existing Mortgage/Loans - Other Currency:  

   Have you ever been declared Bankrupt ?   Yes   No
		 If Yes - Please Specify 

   Have you ever had Court Proceedings against you for outstanding debt ?   Yes   No
		 If Yes - Please Specify 

   Have you ever had an agreement with creditors ?   Yes   No
		 If Yes - Please Specify 



YOUR OVERALL FINANCIAL SITUATION
ALL ASSETS HELD:

   (a) PROPERTY ASSETS:

	   (1) Owned By: 
	   Brief Description (house, flat, letting): 
	   Brief Address: 
	   Rental Income per Year:   Euro:    GBP: 
	   Estimated Property Value: Euro:    GBP: 

	   (2) Owned By: 
	   Brief Description (house, flat, letting): 
	   Brief Address: 
	   Rental Income per Year:   Euro:    GBP: 
	   Estimated Property Value: Euro:    GBP: 

	   (3) Owned By: 
	   Brief Description (house, flat, letting): 
	   Brief Address: 
	   Rental Income per Year:   Euro:    GBP: 
	   Estimated Property Value: Euro:    GBP: 


   (b) ALL OTHER WORLDWIDE ASSETS (Cash, Shares, Investments):

	   First Applicant:
	   (1) Brief Description: 
	   Where Held: 
	   Estimated Value: Euro:    GBP: 

	   (2) Brief Description: 
	   Where Held: 
	   Estimated Value: Euro:    GBP: 

	   (3) Brief Description: 
	   Where Held: 
	   Estimated Value: Euro:    GBP: 

	   (4) Brief Description: 
	   Where Held: 
	   Estimated Value: Euro:    GBP: 


	   Second Applicant:
	   (1) Brief Description: 
	   Where Held: 
	   Estimated Value: Euro:    GBP: 

	   (2) Brief Description: 
	   Where Held: 
	   Estimated Value: Euro:    GBP: 

	   (3) Brief Description: 
	   Where Held: 
	   Estimated Value: Euro:    GBP: 

	   (4) Brief Description: 
	   Where Held: 
	   Estimated Value: Euro:    GBP: 


CURRENT MORTGAGES (property) AND OTHER LOANS (cars, bank loans, overdrafts etc):

	   (Loan 1) Existing Lender: 
	   Is Main Home in Joint Names ?:   YES   NO 
	   Original Loan Amount: Euro:    GBP: 
	   Amount Outstanding:   Euro:    GBP: 
	   Monthly Repayment:    Euro:    GBP: 
	   Period of Loan:  months:     Expiry Date: 
	   Main Home Market Value: euroGBP


	   (Loan 2) Type of Commitment: 
	   Owed To: 
	   Original Loan Amount: Euro:    GBP: 
	   Amount Outstanding:   Euro:    GBP: 
	   Monthly Repayment:    Euro:    GBP: 
	   Period of Loan:  months:     Expiry Date: 


	   (Loan 3) Type of Commitment: 
	   Owed To: 
	   Original Loan Amount: Euro:    GBP: 
	   Amount Outstanding:   Euro:    GBP: 
	   Monthly Repayment:    Euro:    GBP: 
	   Period of Loan:  months:     Expiry Date: 


	   (Loan 4) Type of Commitment: 
	   Owed To: 
	   Original Loan Amount: Euro:    GBP: 
	   Amount Outstanding:   Euro:    GBP: 
	   Monthly Repayment:    Euro:    GBP: 
	   Period of Loan:  months:     Expiry Date: 


	   (Loan 5) Type of Commitment: 
	   Owed To: 
	   Original Loan Amount: Euro:    GBP: 
	   Amount Outstanding:   Euro:    GBP: 
	   Monthly Repayment:    Euro:    GBP: 
	   Period of Loan:  months:     Expiry Date: 


LOAN PROJECT (Property Details):

	   ADDRESS OF PROPERTY TO BE FINANCED:
	        include postcode (if property has been found)
 		 


	   TYPE OF PROPERTY:
   Principal Residence   Secondary Residence   Buy to Let   Leaseback   House Construction 
   Other - Please State 


	   BRIEF DESCRIPTION OF THE PROPERTY BEING ACQUIRED:
   House   Apartment   Other - Please State 
   Old Property   Modern Property   Off Plan Property   Year of Construction (approx) 

   Total Interior Surface Area (all floors) M²:       Total Plot/Land Size: M²Ha


	   NAME AND ADDRESS OF NOTAIRE (SOLICITOR) BEING USED:
	        include postcode (if notaire has been appointed)
 		 

   Proposed Completion Date 
   Loan Required (min. Euro 50.000):  
   Preference Fixed Loan   Variable Loan 


	   TYPE OF INSURANCE REQUESTED:
   Death or Disability (Compulsory)    Inability to Work (optional) 


	   FINANCE PLAN:
				  Property Cost:	       Fees:
	   Purchase:              euroGBP      euroGBP
	   Improvement Work:      euroGBP      euroGBP
	   Total: 		  euroGBP      euroGBP

				  Mortgage Required:	       Personal Contribution:
	   Purchase:              euroGBP      euroGBP
	   Improvement Work:      euroGBP      euroGBP
	   Total: 		  euroGBP      euroGBP


	   MONTHLY PAYMENTS:
				  Mortgage/Rent:	       Car Loan(s):
	   Total: 		  euroGBP      euroGBP


	   ANNUAL INCOME (Net):
	   First Applicant:
	   Salary:                Euro:    GBP: 
	   Bonus:                 Euro:    GBP: 
	   Investment Income:     Euro:    GBP: 
	   Sub-Total:             Euro:    GBP: 
	   Rental Income:         Euro:    GBP: 
	   Total Annual Income:   Euro:    GBP: 


	   ANNUAL INCOME (Net):
	   Second Applicant:
	   Salary:                Euro:    GBP: 
	   Bonus:                 Euro:    GBP: 
	   Investment Income:     Euro:    GBP: 
	   Sub-Total:             Euro:    GBP: 
	   Rental Income:         Euro:    GBP: 
	   Total Annual Income:   Euro:    GBP: 


   When is the finance required ?
        	
   Other comments: